Tekla Shiindi-Mbidi
One of the factors, which affect the population growth, is fertility and in many countries, fertility is looked at as something that has to be respected. In fact, many individuals and most of the couple’s goal is to be parents and to have children of their own blood. It is a wish, a dream and an assumption that when you are older and when the time is right, it is obvious that you will have a family of your own. However, there is a medical reality of involuntary childlessness, which can be devastating to many victims. Infertility is a condition, which manifests itself, unanticipated and unexplainable at times, it affects both men and women and it carries a significant burden of stigma, endured shame and prejudice. Some studies found that infertility stigma was higher for women than for men, making women the primary target of stigma for something that is equally as likely to be caused by men just like women.
It is certainly unfortunate that infertility is a condition which one cannot be aware of until the time an individual and their partner finds themselves struggling to conceive. Although infertility is relatively common, no one ever plans not to be able to conceive, however, wanting to have and having children is seen as a societal norm, which means people who don’t conform to this norm are potentially at risk of experiencing stigma and prejudice. The Windhoek IVF clinic statistics indicate that only about one in six couples concerned with infertility end up seeking help. And within this group, the cause of infertility lies with the woman in up to 40%, while the infertility in the man is about 30% of the cases. The remaining percentage of the cases are either that, both partners have reduced fertility and the cause cannot be determined.
What is infertility, what causes it and can it be treated?
According to the World Health Organisation, infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. In women, infertility can be primary or secondary, where primary infertility is when a woman is unable to ever bear a child due to the inability to become pregnant. Whereas secondary infertility is when a woman has previously carried a pregnancy and have given birth to a live child, but she is no longer able to fall pregnant. The causes of infertility vary from individual to individual in women and men with some causes present at birth and some developing later in life. In addition, documented lifestyle risk factors such as old age, drugs and alcohol use, obesity, underweight and excessive exercises can cause infertility.
Because of the dramatic advancement in medicine and technology, when infertility is diagnosed, a number of known treatments are tailored to individual problems, depending on the factors contributing to the infertility of a couple. Although infertility can be treated, there are reports of a few numbers of treatment failure and sometimes high costs for some individuals and couples. Indeed, many stories about the success of assisted reproductive technologies are known nationally and internationally. In Namibia, it is unfortunate that the assisted reproductive technology services are only available in the private sector, thus making it a barrier for many individual women, men and couples who cannot afford to pay for these services and exposing them to continue facing social infertility stigma.
How can society play a role in ending the stigma?
Some individuals and couples who are affected by infertility tend to suffer from psychological distress. Because of the culture and the taboo of discussing infertility, some women or couples have to suffer in silence when questions such as “when are you going to have a baby”? Or, what are you waiting for? are asked to them.
These questions although true were perceived to make a person feel as heavy and like they are carrying tons of bricks. It is interesting how society expects that it is unnatural for couples if they have not given birth after a certain period of time. It will thus be good if we stop the stigma, give support to those in need and create an environment and support groups where individuals and couples can be allowed talk about infertility without the feeling of being judged for a situation they are in with no choice. In those conducive environments and support groups, questions such as when are you going to have a baby need to be turned into positive comments such as relax, it might just happen when you least expect it. In that conducive environment and through the support group, the victims want to hear the different options available to them, they need to be referred to places which can be of help or could support, and the victims should be told words which will give them hope so that they don’t feel alone.
The realities of infertility should not be seen and judged as individuals or couples fault. It is insensitive and shattering for society to point or blame infertility either to a woman or the man because none of them ever chose to be infertile. In-fact, society should know that all children are miracles and a gift from God, irrespective of whether their parents went through rigorous fertility treatments or not.
We should be lucky to live in an era where assisted reproductive technology has made it a possible option for some. As a nation, we thus need to hold hands, encourage infertility conversations and formation of support groups and educate the public to stop the stigma because infertility stigma is too high, and that is not okay! The stigma of being labelled as infertile is not something anyone wants. It’s hard to wait around for something you know might never happen; it’s even harder to give up when you know it’s everything you want. Be courageous!